Provider Demographics
NPI:1154050805
Name:MCGOWEN, VICTORIA HARDY (DMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:HARDY
Last Name:MCGOWEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:LEIGH
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1313 N B ST
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-9309
Mailing Address - Country:US
Mailing Address - Phone:252-578-6263
Mailing Address - Fax:
Practice Address - Street 1:900 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5200
Practice Address - Country:US
Practice Address - Phone:252-633-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC127821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice